Serial killer and necrophilia: Report of twenty-five years of treatment and management in a rare case.

The authors report a case of a sexual serial killer responsible for four homicides (one homosexual and three prostitutes) over a 12-year period. The perpetrator was diagnosed with a severe personality disorder and necrophilia at the time of the crimes and was declared partially mentally impaired and dangerous to societal security by the Court of Jurisdiction for these crimes. The offender served 22 years in prison, including half of the detention in an OPG (High Security Forensic Psychiatry Hospital) receiving psychiatric treatment. This was followed by 3 years of internment in the REMS (Residences for the Execution of Security Measures): these facilities are regional mental health community facilities, each accommodating 20 patients, established throughout Italian administrative division. Such facilities are designed for the accommodation and treatment of offenders who are either deemed not guilty by reason of insanity (NGRI) or declared totally mentally impaired (Articles 88, Italian Penal Code) or assessed as partially mentally impaired (Article 89 Italian Penal Code), typically following reduced imprisonment terms. The case documents the history of schizophrenic disorder, the development of serial killers' behavior during incarceration, and the comprehensive process of treatment and management that encompasses 25 years. Cases documenting the evolution of the human path and long-term treatment of serial killers remain rarely documented available in the literature.